SUBURBAN OTOLARYNGOLOGY,S.C. (NPI# 1821204082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821204082 |
Entity Type | Organization |
Organization Name | SUBURBAN OTOLARYNGOLOGY,S.C. |
Practice Address |
3340 Oak Park Ave Berwyn IL 60402-3420 |
Practice Telephone | 7087493070 |
Practice Fax Number | 7087493410 |
Mailing Telephone | 7087493070 |
Mailing Fax Number | 7087493410 |
Enumeration Date | 2007-05-15 |
Last Update Date | 2007-12-13 |
Authorized Official Name | LARRY L BAILEY (PRESIDENT) |
Authorized Official Telephone | 7087493070 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 0040148033 | IL | Other Service Providers |
Street Address |
3340 OAK PARK AVE |
City | BERWYN |
State | IL |
Zip Code | 60402-3420 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508862368 | Allen Jerome Rosenbaum | Internal Medicine | 3340 Oak Park Ave, Ste 304, Berwyn, IL 60402-3483 | 2005-06-24 |
1215251269 | Comprehensive Pain Solutions | Clinic/Center | 3340 Oak Park Ave, 314, Berwyn, IL 60402-3420 | 2010-03-19 |
1366626996 | Suburban Urology Associates,ltd | Specialist | 3340 Oak Park Ave, Suite 305, Berwyn, IL 60402-3420 | 2007-12-18 |
1114087962 | Peter Misurec | Urology | 3340 Oak Park Ave, Suite 305, Berwyn, IL 60402-3420 | 2006-12-11 |
1821187923 | Larry L Bailey | Otolaryngology | 3340 Oak Park Ave, Berwyn, IL 60402-3420 | 2006-10-12 |
1588753693 | Daniel M Kurtzman | Otolaryngology | 3340 Oak Park Ave, Berwyn, IL 60402-3420 | 2006-10-12 |
1316044233 | Damayanti S Hathiwala | Pediatrics | 3340 Oak Park Ave, Suite 201, Berwyn, IL 60402-3420 | 2006-09-20 |
1821196643 | Anthony Joseph Guido | Dentist | 3340 Oak Park Ave, Suite 308, Berwyn, IL 60402-3420 | 2006-09-20 |
1376563742 | Jennifer Renee Glover | Surgery | 3340 Oak Park Ave, 309, Berwyn, IL 60402-3420 | 2006-07-20 |
1992731491 | Neurologic Care Associates, P.C. | Psychiatry & Neurology | 3340 Oak Park Ave, Suite 200, Berwyn, IL 60402-3420 | 2006-06-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
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Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821525403 | Maria Espejo-schiltz | Specialist | 3245 Grove Ave Ste 205, Berwyn, IL 60402-3476 | 2017-05-15 |
1316014723 | Medical Surgical Dermatology, Sc | Specialist | 3253 Harlem Ave, Berwyn, IL 60402-2996 | 2006-11-29 |
1710967989 | Allen C. Bernthal | Specialist | 6827 Stanley Ave, Berwyn, IL 60402-3287 | 2006-01-22 |
1477974574 | Integrated Pain Management (berwyn) Ltd | Specialist | 3253 Harlem Ave, Unit 5, Berwyn, IL 60402-2996 | 2013-12-17 |
1366763534 | Allen C Bernthal M D Ltd | Specialist | 6827 Stanley Ave, Berwyn, IL 60402-3287 | 2010-06-22 |
1659690022 | Suburban Metabolic Institute, LLC | Specialist | 3245 Grove Ave, Ste. 202, Berwyn, IL 60402-3474 | 2010-05-25 |
1366626996 | Suburban Urology Associates,ltd | Specialist | 3340 Oak Park Ave, Suite 305, Berwyn, IL 60402-3420 | 2007-12-18 |
1750436051 | Gi and Liver Specialists, Ltd | Specialist | 6827 Stanley Ave, Berwyn, IL 60402-3287 | 2007-01-24 |
1548315849 | Midwest Nephrology Associates, LLC | Specialist | 6827 Stanley Ave, Berwyn, IL 60402-3287 | 2007-01-24 |
1184701328 | Berwyn Emergency Services Sc | Specialist | 3635 Harlem Ave, Berwyn, IL 60402-3212 | 2006-11-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.